Agenda item

1.    The item was introduced by Diane Morton, Cabinet Member for Adult Social Care, who highlighted the importance of scrutinising winter preparedness and system reliance across health and social care. She also relayed encouraging progress in reducing corridor care through collaborative working across partners and thanked Adult Social Care staff for their contributions to improvements. 

2.    In response to questions and comments from Members, discussion covered the following: 

a)    Members praised the report for its level of detail and clarity and expressed their appreciation to officers for their work in its preparation. 

b)    Sarah Hammond, Interim Corporate Director for Adult Social Care and Health, advised that staff vacancies were being addressed through national and local recruitment initiatives, and that approval had been given to recruit to all identified frontline roles; however, attracting sufficient applicants remained the key challenge. Michael Thomas- Sam, Director of Operations (Short- Term Support), added that the strategy intended to focus on staff retention, support and career development, alongside recruitment. The importance of the enablement function in managing demand, particularly during winter, was emphasised, and vacancy rates across the sector continued to be monitored. 

c)    Dr Anjan Ghosh, Director of Public Health, acknowledged that flu vaccination uptake in schools remained low, reflecting national challenges such as vaccine hesitancy and operational issues. He also outlined that work was ongoing with partners to improve uptake, although delivery sat with NHS organisations. 

d)    Dr Ghosh agreed to explore future reporting including comparisons showing vaccination uptake alongside flu incidence rates, to better understand correlation. However, he advised that while population- level data may be available demonstrating that vaccination was generally effective, its impact varied from year to year. It was explained that flu vaccination uptake was continuously monitored and supported through ongoing campaigns and targeted engagement with underrepresented groups. Catch-up arrangements were also in place, particularly within schools, although coverage in wider populations relied on continued promotion and access. It was also advised that vulnerable individuals at risk of isolation were identified and supported through joint working between NHS and Adult Social Care services. 

e)    Mr Thomas- Sam outlined that the Technology- Enhanced Life (TEL) programme was delivering positive outcomes by supporting monitoring and early intervention. It was highlighted as a key part of the prevention agenda, with further work required to expand uptake, including increased awareness and use across care settings. Ms Hammond further highlighted ongoing engagement work to increase acceptance of the technology, alongside plans to pilot its use with care providers to support vulnerable residents and reduce the risk of falls. Miss Morton added that a digital patient monitoring system in nursing homes across the county had delivered positive outcomes in supporting residents to remain at home. She confirmed that funding had been secured to continue and expand the programme into the future.

f)     Ms Hammond explained that reducing reliance on residential care pathways would require more flexible, community- based services, combining social care with elements of health support. She highlighted that while the enablement service had been effective, further integration was needed. Furthermore, no additional government funding was currently anticipated, although opportunities would be pursued if they arose. Mr Thomas- Sam further outlined that in- house residential provision supported discharge and rehabilitation, enabling a significant proportion of individuals to return to their own homes, and emphasised the importance of a coordinated system response to manage demand pressures. 

g)    Mr Thomas- Sam confirmed that examples of good practice had been identified, particularly in the delivery of enhanced community- based support. Work was underway with partners to develop a countywide model to share and replicate successful approaches. 

h)    Dr Ghosh advised that vaccination data was reported as percentage uptake. He explained that population changes and shifts between age cohorts created additional challenges, although overall population change in Kent was limited. He also offered to provide additional demographic information to contextualise vaccination data, including population trends across age cohorts. Miss Morton added that a Kent- wide vaccination strategy was in development and would be brought forward in due course. 

i)     Miss Morton advised that responsibility for flu vaccination delivery and messaging largely sat with NHS providers and commissioned providers. Dr Ghosh emphasised that vaccination was a key public health intervention, but uptake was influenced by a range of factors beyond communication campaigns. Efforts to improve uptake included enhanced messaging, addressing logistical challenges, and reviewing broader system factors. Work was also underway with partners to refresh the vaccination strategy across all programmes. 

j)     Ms Hammond explained that eligibility criteria, including changes to free vaccine access for certain groups, may have impacted uptake, alongside wider factors influencing vaccination rates. She added that, in her view, any impact on vaccine uptakes were not related to cost, but rather to the ease of accessing vaccination. 

k)    It was acknowledged that vaccine uptake among care workers had declined, but this was addressed through a targeted post?Christmas programme, with assurance that lessons had been learned and actions taken. 

l)     Ms Hammond advised that, although average lengths of stay in a care setting had increased, the overall number of people requiring adult social care had reduced. She indicated that this could suggest a positive impact on longer- term demand, while emphasising that the primary challenge remained the cost of individual care packages. 

m)  Mr Thomas- Sam confirmed that, although there had been a delay, fire safety works at Broadmeadow were on track. He also reported that targeted approaches to TELs were being developed through integrated neighbourhood teams, with a focus on identifying and supporting higher- risk individuals, and that further work would be considered to expand this approach. Miss Morton highlighted that additional TEL sessions would be delivered in libraries across Kent to improve accessibility and support public engagement with technology. 

n)    Ms Hammond confirmed that a forthcoming review would cover all aspects of the Better Care Fund. Progress had been delayed pending resolution of financial arrangements with the Integrated Care Board (ICB), which was close to agreement after which work on its future use would proceed. 

o)    Dr Ghosh advised that it would not be possible to calculate the counterfactual impact of flu vaccination at a local level due to technical complexity, but that analysis would focus on correlations between vaccination uptake and flu incidence. 

3.    Following the questions, the Chairman welcomed comments and views from the Committee about the item. These included: 

a)    A Member highlighted previous discussion on staff vacancies and vaccination uptake across cohorts and concurred with officers that these be kept under regular review. It was further suggested that additional analysis be provided on how percentage figures related to absolute numbers, to give a clearer understanding of trends across different cohorts, and that the Adult Social Care and Public Health Committee receive a report on this topic. 

b)    A Member emphasised the role of local leaders in supporting Adult Social Care and Public Health by promoting the importance of the flu vaccination programme and encouraging consistent messaging within their respective groups. 

c)    A Member expressed support for amplifying flu vaccination messaging and highlighted the range of communication channels, including social media, available to support this effort. 

d)    A Member welcomed the identification of key issues and requested that updates on lessons learned, pilots, and rollout activity be reported back to support Members in providing reassurance within their communities. 

e)    A Member reiterated a request that comparable data on vaccine uptake and flu impact be presented side by side, where possible, to provide clearer understanding, while recognising the limitations of statistical comparisons. A Member also emphasised the importance of including the accuracy of predictions alongside this data. 

4.    The Chairman summarised the debate and highlighted key areas for onward consideration for the Adult Social Care and Public Health Cabinet Committee, including the review of the Better Care Fund, the upcoming vaccination programme alongside the comments made by the Scrutiny Committee on that topic, and the role of local leadership in promoting uptake. The Chairman also commended the quality of the report and thanked officers for their work. The Chairman proposed to note the report and this was agreed by the Committee. 

5.    RESOLVED that the Scrutiny Committee note the report.